TNCC test prepA, TNCC Notes for
Written Exam, TNCC Notes for Written
Exam, TNCC Prep, TNCC EXAM, TNCC
8th Edition
Expedite transfer to the closest trauma center - ansA 56 y/o M pt involved in a motor vehicle
crash is brought to the ED of a rural critical access facility. He complains of neck pain, SOB,
and diffuse abd pain. His GCS is 15. His VS: BP 98/71, HR 125, RR 26, SpO2 94% on high-
flow O2 via NRB mask. Which of the following is the priority intervention for this patient?
a pertinent medical hx is crucial - ansWhich of the following considerations is the most
important when caring for a geriatric trauma pt?
Mitigation - ansFollowing a review of recent drills and a real disaster event, a hospital has
identified deficiencies and is taking steps to minimize the impact of a future disaster . Which
phase of the disaster life cycle does this describe?
Multiple requests for water - ansEMS brings a pt who fell while riding his bicycle. Using the
American College of Surgeobs screening guidelines, which assessment finding would prompt
the RN to prepare the pt for a radiologic spine clearance?
hemoglobin does not readily release O2 for use by the tissues - ansWhat is the effect of
hypothermia on the oxyhemoglobin dissociation curve?
acidosis - ansWhich of the following is a component of the trauma triad of death?
Complete - ansEMS brings a pt from MVC. VS: BP 90/49, HR 48, RR 12, temp 97.2F (36.2
C). The pt exhibits urinary incontinence and priapism. These assessment findings are most
consistent with which of the following types of spinal cord injury?
flucuation in the water seal chamber - ansWhich of the following is an expected finding in a
pt with a tube thoracstomy connected to a chest drainage system?
insert an oropharyngeal airway if there is no gag reflex - ansDuring the primary survey of an
unconscious pt with multi-system trauma, the nurse notes snoring respirations. What priority
nursing interventions should be preformed next?
globe rupture - ansA 35 y/o M presents with facial trauma after being struck in the face with a
baseball. A teardrop-shaped left pupil is noted on exam. What type of injury is suspected?
compensated - ansA trauma pt is restless and repeatedly asking "where am i?" VS upon
arrival: BP 110/60, HR96, RR 24. Her skin is cool and dry. Current VS are BP 104/84, HR
108, RR 28. The pt is demonstrating s/sx of which stage of shock?
,ventilate with a bag mask device - ansAn unresponsive trauma pt has an oropharygeal airway
in place, shallow and labored respirations, and dusky skin. The trauma team has administered
medications for drug-assisted intubation and attempted intubation but was unsuccessful.
What is the most appropriate immediate next step?
within 24 hrs of trauma - ansWhen is the tertiary survey completed fora trauma pt?
pressure - ansAn intubated and sedated pt in the ED has multiple extremity injuries with the
potential for causing compartment syndrome. What is the most reliable indication of
compartment syndrome in a patient who is unconscious?
worsening pneumothorax - ansWhich of the following is possible complication of positive-
pressure ventilation?
pelvic stability - ansthe most reassuring finding for a male pt with hip pain after a fall is
which of the following?
narrowed - ansWhich of the following pulse pressures indicate early hypovolemic shock?
dysrhythmias - ansPatients with a crush injury should be monitored for which of the
following conditions?
subdural hematoma - ansTearing of the bridging veins is most frequently associated with
which brain injury?
straight cath for urine sample - ansA 20 y/o M presents to the ED complaining of severe
lower abd pain after landing hard on the bicycle cross bars while preforming an aerial BMX
maneuver. Secondary assessment reveals lower abd tenderness and scrotal ecchymosis.
Which of the following orders would the RN question?
placental abruption - ansYou are caring for a pt who was involved in a MVC and is 32 weeks
pregnant. Findings of your secondary survey include abd pain on palpation, fundal ht at the
costal margin, and some dark bloody show. Varying accelerations and decelerations are noted
on cariocgraphy. These findings are most consistent with which of the following?
it can worsen cord damage from an unstable spinal injury - ansWhich of the following is true
about the log-roll?
defusings - ansAll of these are considered a critical communication point in trauma care
EXCEPT which of the following?
pulse oximetry and capnography - ansWhat bedside monitoring parameters are used to assess
for adequacy of O2 and effectiveness of ventilation?
padding the upper back while stabilizing the cervical spine - ansCaregivers carry in a 2 y/o
into the ED who fell out of a second-story window. The pt is awake and crying with
increased work of breathing and pale skin. Which of the following interventions has the
highest priority?
bowel - ansWhich of the following injuries is LEAST likely to be promptly identified?
,Initiate transfer to a trauma center - ansA pt is brought to the ED of a rural hospital following
a high-speed MVC. When significant abd and pelvic injuries are noted in the primary survey,
which of the following is the priority interventions?
bardycardia and absent motor function below the level of injury - ansA pt with a complete
spinal cord injury in neurogenic shock will demonstrate hypotension and which other clinical
signs?
apply splint and elevate above the level of the heart - ansa 37 y/o F has a deformity of the L
wrist after a fall. She is reluctant to move her hand due to pain. Which of the following is the
most appropriate intervention?
the aorta is torn at its attachment with the ligamentum arteriosum - answhich of the following
occurs during the third impact of a motor vehicle crash?
Report your suspicion of maltreatment in accordance with local regulations - ansa 5 y/o child
presents to the ED with bruises to the upper arm and buttocks in various stages of healing and
multiple small, clean, round burns to the back. There are no abnormalities found based on the
pediatric assessment triangle or primary survey. Which of the following is the priority survey.
Which of the following is the priority nursing intervention?
to guage end-organ perfusion and tissue hypoxia - ansWhy is a measure of serum lactate
obtained in the initial assessment of a trauma patient?
elevating the extremity to the level of the heart - ansA pt with a lower extremity fracture
complains of severe pain and tightness in his calf, minimally by pain medications. Which of
the following is the priority nursing intervention?
velocity - ansWhat factor contributes most to the kinetic energy of a body in motion?
subdural hematoma - ansAn elderly patient with a history of anticoagulant use presents after a
fall at home today. She denies any loss of consciousness. She has a hematoma to her forehead
and complains of headache, dizziness, and nausea. What is the most likely cause of her
symptoms?
fat embolism - ansa pt has been in the ED for several hrs waiting to be admitted. He sustained
multiple rib fractures and a femur fracture after a fall. He has been awake, alert, and
complaining of leg pain. His wife reported that he suddenly became anxious and confused.
Upon reassessment, the pt is restless with respiratory distress and petechiae to his neck. The
pt is exhibiting s/sx most commonly associated with which of the following conditions?
nausea and vomiting - ansWhich of the following is a late sign of increased intracranial
pressure?
serial FAST exams - ansa 49 y/o restrained driver involved in a MVC presents to the trauma
center complaining of abd, pelvic, and bilateral lower extremity pain. VS are stable. The
nurse can anticipate all of these after a negative FAST exam EXCEPT which of the
following?
, pericardiocentesis - ansWhich of the following is NOT considered goal-directed therapy for
cardiogenic shock?
endotracheal tube - ansThe trauma nurse knows that placing a bariatric patient in a ramped
position providers better visualization during the insertion of which device?
increased work of breathing? - answhich of the following assessment findings differentiates a
tension pneumothorax from a simple pneumothorax?
calcium - ansif a pt has received multiple transfusions of banked blood preserved with citrate,
which electrolyte is most likely to drop and require supplementation?
identifying individuals who made mistakes during the traumatic event - ansWhich of the
following is NOT considered a benefit of debriefings?
500 mL/hr - ansYou are treating a 27 y/o M in respiratory distress who was involved in a
house fire. Calculating TBSA burned is deferred due to the need for emergent intubation. At
what rate should you begin fluid resuscitation?
advanced age - ansWhich of the following is most likely to contribute to inadequate
oxygenation and ventilation?
a 52 y/o diabetic male with a partial thickness burn to the left lower leg - ansWhich of the
following patients warrants referral to a burn center?
dressing removal - ansA patient arrives with a large open chest wound after being assaulted
with a machete. Prehospital providers placed a nonporous dressing over the chest wound and
taped it on three sides. he is now showing signs of anxiety, restlessness, severe respiratory
distress, cyanosis and decreasing blood pressure. Which of the following is the MOST
appropriate immediate intervention?
after a physical examination if the pt has no radiologic abnormalities on CT - ansEMS arrives
with the intoxicated driver of a car involved in a MVC. EMS reports significant damage to
the drivers side of the car. The pt is asking to have the cervical collar removed. When it is
appropriate to remove the cervical collar?
MARCH - ansWhich of the following mnemonics can help the nurse prioritize care for a
trauma patient with massive uncontrolled hemorrhage?
What is kinematics? - ansA branch of mechanics (energy transfer) that refers to motion and
does not consider the concepts of force and mass of the object or body.
What is Newton's First Law? - ansA body at rest will remain at rest. A body in motion will
remain in motion until acted on by an outside force.
What is the Law of Conservation of Energy? - ansEnergy can neither be created nor
destroyed. It is only changed from one form to another.
What is Newton's Second Law? - ansForce equals mass multiplied by acceleration of
deceleration.
Written Exam, TNCC Notes for Written
Exam, TNCC Prep, TNCC EXAM, TNCC
8th Edition
Expedite transfer to the closest trauma center - ansA 56 y/o M pt involved in a motor vehicle
crash is brought to the ED of a rural critical access facility. He complains of neck pain, SOB,
and diffuse abd pain. His GCS is 15. His VS: BP 98/71, HR 125, RR 26, SpO2 94% on high-
flow O2 via NRB mask. Which of the following is the priority intervention for this patient?
a pertinent medical hx is crucial - ansWhich of the following considerations is the most
important when caring for a geriatric trauma pt?
Mitigation - ansFollowing a review of recent drills and a real disaster event, a hospital has
identified deficiencies and is taking steps to minimize the impact of a future disaster . Which
phase of the disaster life cycle does this describe?
Multiple requests for water - ansEMS brings a pt who fell while riding his bicycle. Using the
American College of Surgeobs screening guidelines, which assessment finding would prompt
the RN to prepare the pt for a radiologic spine clearance?
hemoglobin does not readily release O2 for use by the tissues - ansWhat is the effect of
hypothermia on the oxyhemoglobin dissociation curve?
acidosis - ansWhich of the following is a component of the trauma triad of death?
Complete - ansEMS brings a pt from MVC. VS: BP 90/49, HR 48, RR 12, temp 97.2F (36.2
C). The pt exhibits urinary incontinence and priapism. These assessment findings are most
consistent with which of the following types of spinal cord injury?
flucuation in the water seal chamber - ansWhich of the following is an expected finding in a
pt with a tube thoracstomy connected to a chest drainage system?
insert an oropharyngeal airway if there is no gag reflex - ansDuring the primary survey of an
unconscious pt with multi-system trauma, the nurse notes snoring respirations. What priority
nursing interventions should be preformed next?
globe rupture - ansA 35 y/o M presents with facial trauma after being struck in the face with a
baseball. A teardrop-shaped left pupil is noted on exam. What type of injury is suspected?
compensated - ansA trauma pt is restless and repeatedly asking "where am i?" VS upon
arrival: BP 110/60, HR96, RR 24. Her skin is cool and dry. Current VS are BP 104/84, HR
108, RR 28. The pt is demonstrating s/sx of which stage of shock?
,ventilate with a bag mask device - ansAn unresponsive trauma pt has an oropharygeal airway
in place, shallow and labored respirations, and dusky skin. The trauma team has administered
medications for drug-assisted intubation and attempted intubation but was unsuccessful.
What is the most appropriate immediate next step?
within 24 hrs of trauma - ansWhen is the tertiary survey completed fora trauma pt?
pressure - ansAn intubated and sedated pt in the ED has multiple extremity injuries with the
potential for causing compartment syndrome. What is the most reliable indication of
compartment syndrome in a patient who is unconscious?
worsening pneumothorax - ansWhich of the following is possible complication of positive-
pressure ventilation?
pelvic stability - ansthe most reassuring finding for a male pt with hip pain after a fall is
which of the following?
narrowed - ansWhich of the following pulse pressures indicate early hypovolemic shock?
dysrhythmias - ansPatients with a crush injury should be monitored for which of the
following conditions?
subdural hematoma - ansTearing of the bridging veins is most frequently associated with
which brain injury?
straight cath for urine sample - ansA 20 y/o M presents to the ED complaining of severe
lower abd pain after landing hard on the bicycle cross bars while preforming an aerial BMX
maneuver. Secondary assessment reveals lower abd tenderness and scrotal ecchymosis.
Which of the following orders would the RN question?
placental abruption - ansYou are caring for a pt who was involved in a MVC and is 32 weeks
pregnant. Findings of your secondary survey include abd pain on palpation, fundal ht at the
costal margin, and some dark bloody show. Varying accelerations and decelerations are noted
on cariocgraphy. These findings are most consistent with which of the following?
it can worsen cord damage from an unstable spinal injury - ansWhich of the following is true
about the log-roll?
defusings - ansAll of these are considered a critical communication point in trauma care
EXCEPT which of the following?
pulse oximetry and capnography - ansWhat bedside monitoring parameters are used to assess
for adequacy of O2 and effectiveness of ventilation?
padding the upper back while stabilizing the cervical spine - ansCaregivers carry in a 2 y/o
into the ED who fell out of a second-story window. The pt is awake and crying with
increased work of breathing and pale skin. Which of the following interventions has the
highest priority?
bowel - ansWhich of the following injuries is LEAST likely to be promptly identified?
,Initiate transfer to a trauma center - ansA pt is brought to the ED of a rural hospital following
a high-speed MVC. When significant abd and pelvic injuries are noted in the primary survey,
which of the following is the priority interventions?
bardycardia and absent motor function below the level of injury - ansA pt with a complete
spinal cord injury in neurogenic shock will demonstrate hypotension and which other clinical
signs?
apply splint and elevate above the level of the heart - ansa 37 y/o F has a deformity of the L
wrist after a fall. She is reluctant to move her hand due to pain. Which of the following is the
most appropriate intervention?
the aorta is torn at its attachment with the ligamentum arteriosum - answhich of the following
occurs during the third impact of a motor vehicle crash?
Report your suspicion of maltreatment in accordance with local regulations - ansa 5 y/o child
presents to the ED with bruises to the upper arm and buttocks in various stages of healing and
multiple small, clean, round burns to the back. There are no abnormalities found based on the
pediatric assessment triangle or primary survey. Which of the following is the priority survey.
Which of the following is the priority nursing intervention?
to guage end-organ perfusion and tissue hypoxia - ansWhy is a measure of serum lactate
obtained in the initial assessment of a trauma patient?
elevating the extremity to the level of the heart - ansA pt with a lower extremity fracture
complains of severe pain and tightness in his calf, minimally by pain medications. Which of
the following is the priority nursing intervention?
velocity - ansWhat factor contributes most to the kinetic energy of a body in motion?
subdural hematoma - ansAn elderly patient with a history of anticoagulant use presents after a
fall at home today. She denies any loss of consciousness. She has a hematoma to her forehead
and complains of headache, dizziness, and nausea. What is the most likely cause of her
symptoms?
fat embolism - ansa pt has been in the ED for several hrs waiting to be admitted. He sustained
multiple rib fractures and a femur fracture after a fall. He has been awake, alert, and
complaining of leg pain. His wife reported that he suddenly became anxious and confused.
Upon reassessment, the pt is restless with respiratory distress and petechiae to his neck. The
pt is exhibiting s/sx most commonly associated with which of the following conditions?
nausea and vomiting - ansWhich of the following is a late sign of increased intracranial
pressure?
serial FAST exams - ansa 49 y/o restrained driver involved in a MVC presents to the trauma
center complaining of abd, pelvic, and bilateral lower extremity pain. VS are stable. The
nurse can anticipate all of these after a negative FAST exam EXCEPT which of the
following?
, pericardiocentesis - ansWhich of the following is NOT considered goal-directed therapy for
cardiogenic shock?
endotracheal tube - ansThe trauma nurse knows that placing a bariatric patient in a ramped
position providers better visualization during the insertion of which device?
increased work of breathing? - answhich of the following assessment findings differentiates a
tension pneumothorax from a simple pneumothorax?
calcium - ansif a pt has received multiple transfusions of banked blood preserved with citrate,
which electrolyte is most likely to drop and require supplementation?
identifying individuals who made mistakes during the traumatic event - ansWhich of the
following is NOT considered a benefit of debriefings?
500 mL/hr - ansYou are treating a 27 y/o M in respiratory distress who was involved in a
house fire. Calculating TBSA burned is deferred due to the need for emergent intubation. At
what rate should you begin fluid resuscitation?
advanced age - ansWhich of the following is most likely to contribute to inadequate
oxygenation and ventilation?
a 52 y/o diabetic male with a partial thickness burn to the left lower leg - ansWhich of the
following patients warrants referral to a burn center?
dressing removal - ansA patient arrives with a large open chest wound after being assaulted
with a machete. Prehospital providers placed a nonporous dressing over the chest wound and
taped it on three sides. he is now showing signs of anxiety, restlessness, severe respiratory
distress, cyanosis and decreasing blood pressure. Which of the following is the MOST
appropriate immediate intervention?
after a physical examination if the pt has no radiologic abnormalities on CT - ansEMS arrives
with the intoxicated driver of a car involved in a MVC. EMS reports significant damage to
the drivers side of the car. The pt is asking to have the cervical collar removed. When it is
appropriate to remove the cervical collar?
MARCH - ansWhich of the following mnemonics can help the nurse prioritize care for a
trauma patient with massive uncontrolled hemorrhage?
What is kinematics? - ansA branch of mechanics (energy transfer) that refers to motion and
does not consider the concepts of force and mass of the object or body.
What is Newton's First Law? - ansA body at rest will remain at rest. A body in motion will
remain in motion until acted on by an outside force.
What is the Law of Conservation of Energy? - ansEnergy can neither be created nor
destroyed. It is only changed from one form to another.
What is Newton's Second Law? - ansForce equals mass multiplied by acceleration of
deceleration.
